If Republicans are planning to repeal Obamacare on Jan. 3 and then come looking for help from Democrats to replace it down the road, Senate Democrats have a message for them: It’s not happening.
Among leadership and rank-and-file Senate Democrats, consensus is building to stay unified and not cave to GOP pressure to help fix a health care system that Republicans could send into a tailspin with an outright repeal of President Barack Obama’s signature health care legislation at the beginning of next year.
“Our position is you guys have had seven years since March of 2010 when you said you needed something else. You’re not willing to talk about a replacement yet?” said Sen. Tim Kaine (D-VA). “If they came to us and said we would like to talk to you about something, and we’ll call it replacement and you’ll call it reform, we would sit and talk, but if it starts with repeal, they’re telling us they don’t want us involved.”
Democrats said that they would be willing to sit down and hash out plans to get the Obamacare marketplace working better, but at the moment, Republicans appear to be set on a strategy that fully repeals Obamacare with a promise to replace it down the road.
“Just an across-the-board repeal without any idea of how we are going to provide health care for millions of Americans is simply irresponsible,” Sen. Gary Peters (D-MI) told TPM in an interview. “If they repeal it, it’s going to be on them.”
If Republicans are counting on incoming minority leader Sen. Chuck Schumer (D-NY) to be a dealmaker down the road, it doesn’t look as though that is going to happen. In his most forceful statement yet, Schumer had a message for his counterparts preparing to rip out Obamacare root and branch.
“To our Republican friends across the aisle, bring it on,” Schumer said.
McConnell announced Tuesday that the repeal would be the first order of business in January, but Republicans are still light on the details of how long the phaseout of Obamacare would take, what the fall out would be and how they plan to preserve popular aspects of the law like ensuring people with pre-existing conditions can get health care without seeing premiums skyrocket.
“It’s hard to figure out how to respond to something that is just vague as where they are right now,” said Sen. Sheldon Whitehosue (D-RI). “We’ve heard them talking about repeal and replace now for seven years and they’ve never had a replacement in seven years. I think the hard part for them is that there are elements of the bill that they know they would be crazy to try to undo.”
A major unanswered parliamentary procedure question still remains: Will Senate Republicans even need Democrats to replace key provisions of the law? Republicans can use a budget process called reconciliation to repeal Obamcare. That procedural maneuver allows them to repeal it with a simple 51-vote threshold in the Senate. But replacing the law is more complicated and it may require Democratic buy-in.
“What we are trying to figure out is what the restrictions on reconciliation,” Sen. Dean Heller (R-NV) told TPM. “Does reconciliation allow for a replacement? And it may or may not.”
Sen. Lamar Alexander (R-TN), the chairman of the HELP committee, has said he believes Democrats will need to be part of the process if Republicans are serious about a long-term reform, but several Democrats said they weren’t aware of any formal conversations happening at this point to bring them to the table.
The uncertainty is making insurers nervous.
On Tuesday, American Health Insurance Plans, a group that represents health insurers, laid out what they expected from Republicans if they move forward with their repeal plan.
Marketplaces are already unstable in some places and insurers warn that Republicans risk endangering the markets even more if they rush to repeal the ACA without a suitable transition period or plan to replace it. Among their chief concerns, insurers want to make sure that they will continue to get subsidies from the government to cover low-income individuals on the exchanges.
“The market has already been a little wobbly this year,” Marilyn Tavenner, the chief executive of America’s Health Insurance Plans told the New York Times. “If insurance companies believe cost-sharing subsidies will not continue, they are going to pull out of the market during the next logical opportunity.”
It’s complicated, but Democrats don’t have much sympathy.
“I think they’re setting a trap for themselves,” said Sen. Brian Schatz (D-HI). “I can’t understand how this either goes well for them politically or it goes well for the tens of millions of people who depend on the Affordable Care Act.”
The one wild card will be how Senate Democrats running for re-election in 2018 respond. Republicans may be counting on vulnerable Democrats to feel the heat in 2017 and 2018 and get some motivation to help them, but a leadership aide said that wasn’t likely.
“Republicans lost their safety blanket when they won the White House,” the aide said. “They shouldn’t repeal and then coming begging for help from Democrats to get out of the political mess they’ve created. They campaigned on this for three straight election cycles, its time for them to own the consequences.”